Bronchoscope adapter and method

ABSTRACT

A bronchoscope adapter is configured for one hand operation by providing a slide lock that is captured within a housing and a retaining nut that can be operated with a single finger or thumb. Rotation of the retaining nut is eased by isolating rotational force from a compression block with a spacer ring.

CROSS-REFERENCE TO RELATED APPLICATIONS Background of the Invention

The present invention relates to bronchoscopy and, in particularadapters and bronchoscopy-related accessories for use when performingsurgical procedures using a bronchoscope.

The most common interventional procedure in the field of pulmonarymedicine is bronchoscopy, in which a bronchoscope is inserted into theairways through the patient's nose or mouth. The structure of abronchoscope generally includes a long, thin, flexible tube thattypically contains three elements: an illumination assembly forilluminating the region distal to the bronchoscope's tip via an opticalfiber connected to an external light source; an imaging assembly fordelivering back a video image from the bronchoscope's distal tip; and alumen or working channel through which instruments may be inserted,including but not limited to diagnostic (e.g., biopsy tools) andtherapeutic (e.g., laser, cryo or RF tissue elimination probes)instruments. The distal tip of a bronchoscope is steerable. Rotating alever placed at the handle of the bronchoscope actuates a steeringmechanism which deflects the tip in one or more directions.

Bronchoscopies are performed by expert pulmonologists, also known asbronchoscopists, and are used routinely in the diagnosis and treatmentof conditions such as lung cancer, airway stenosis, and emphysema.Bronchoscopies are typically performed by a staff of at least twopersons: the bronchoscopist and at least one assistant, usually a nurse.During a typical procedure, the bronchoscopist holds the bronchoscopehandle with one hand and the bronchoscope tube with the other hand. Heor she manipulates the distal tip of the bronchoscope inside the lung byrotating a deflection lever and by pushing and pulling the tube. Oncethe tip is brought to a target, a bronchoscope tool can be inserted intothe working channel to perform a diagnostic or therapeutic procedure.

During insertion and operation of the bronchoscopic tool, the distal tipof the bronchoscope should be held steady at the target. Performing allof these tasks concurrently often requires the hands of more than oneperson. Two hands are needed to secure the bronchoscope in place, andone to two more hands are needed for inserting and actuating thebronchoscopic tool. Performing a procedure that requires two people isgenerally more expensive and the potential for error is increased.Hence, it is desirable to modify a procedure so that it may be performedwith one or two hands, if possible.

Of particular relevance to the present invention is a device and methoddescribed in PCT Patent Publication No. WO 03/086498 entitled “EndoscopeStructure and Techniques for Navigation in Branched Structure” toGilboa, which is hereby incorporated by reference in its entirety. Thispatent application describes a method and apparatus in which a locatableguide (“LG”), enveloped by a sheath, is used to navigate a bronchoscopictool to a location within the lung. The LG/sheath combination isinserted into the lung via the working channel of a bronchoscope. Oncethe tip of the guide is located at its target, a lock, which is placedat the orifice (“connection port”) of the bronchoscope's workingchannel, is operated to prevent the sheath from sliding in or out of thebronchoscope. The guide is then withdrawn from the sheath, leaving thesheath in place to guide a tool to the required target location.

One of the many tools often used with a bronchoscope is a vacuum pump. Avacuum pump is used to clear mucus from the airways. In order for thevacuum pump to work properly, it must be attached to the bronchoscopeusing a connector that will form a seal with the proximal orifice of theworking channel. Hence, when transitioning from the use of a locatableguide to the use of a vacuum pump or other tools, a sealing device mustbe unlocked during the tool exchange and then locked down onto the toolprior to use.

Additionally, because all of the tools used with a bronchoscope arenecessarily long and slender, they are inherently flimsy whenunsupported. Thus, inserting a tool into a bronchoscope can be difficultor impossible to do quickly with one hand. While this problem can beaddressed easily by holding the end of the sheath in one hand and thetool in another, this would again require additional free hands duringperformance of the procedure.

In order to facilitate operation of a system such as described in theaforementioned application by a single practitioner, it would bepreferable to allow the practitioner to temporarily release his or hergrip on a secondary tool or device used via the working channel of thebronchoscope. At the same time, it is preferable that the device remainsimmediately accessible and operable, and does not hang loosely.

There is therefore a need for an adaptor for use with a bronchoscopewhich would facilitate operation of a bronchoscope and associated toolsby a single practitioner. It would also be advantageous to provide anadapter for the connection port of the working channel of a bronchoscopewhich would perform both the sealing and tool-locking functions withoutrequiring replacement of an attachment during the procedure. It wouldfurther be advantageous to provide an arrangement according to theteachings of the aforementioned PCT patent publication which wouldfurther facilitate insertion of tools into the guide sheath.

SUMMARY OF THE INVENTION

The present invention relates to an adaptor for use on a bronchoscopehandle when performing surgical procedures using a bronchoscope.

One aspect of the present invention provides a sealing and lockingadapter for attachment to an access port of a working channel of abronchoscope to allow insertion and locking of a tool while sealing theaccess port when not in use. The adapter comprises a housing configuredfor mating with the access port of the working channel of thebronchoscope. A sealing arrangement deployed within the housing and aclamping arrangement deployed within the housing lock a tool insertedthrough the housing and into the working channel in position.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 is a perspective view of a prior art bronchoscope adapter;

FIG. 2A is a perspective view of a prior art bronchoscope adapter beingplaced on a bronchoscope handle;

FIG. 2B is a perspective view of a prior art bronchoscope adapter placedon a bronchoscope handle;

FIG. 3 is an exploded perspective view of an embodiment of abronchoscope adapter of the present invention;

FIG. 4 is an exploded cutaway perspective view of the bronchoscopeadapter of FIG. 3; and

FIG. 5 is an assembled cutaway perspective view of the bronchoscopeadapter of FIG. 3.

DETAILED DESCRIPTION OF THE INVENTION

Referring now to Figures, and first to FIGS. 1 and 2, a bronchoscopeadapter known in the prior art is shown. The bronchoscope adapter 1attaches to an access port 2 leading to a working channel 3 inside of abronchoscope handle 4. The adapter 1 allows the insertion and locking ofa tool (not shown) and serves to seal the access port 2 when not in use.The prior art adapter 1 includes a housing 5 configured for mating withthe access port 2. The housing 5 is first positioned so as to envelopthe access port 2 (FIG. 2a ), and then a forked key 6 is inserted into aslot 7 to attach and maintain contact pressure between the adapter 1 andan input orifice 8 that leads to the working channel 3 (FIG. 2b ). Theseprior art devices and methods are described in detail in PCT PatentPublication No. WO05/025635 entitled “System of Accessories for Use withBronchoscopes” to Greenburg et al., which is herein incorporated byreference in its entirety.

Tools are insertable into the working channel 3 through the inputorifice 8. The working channel 3 extends through the entire length ofthe bronchoscope. The working channel 3 is connectable to a vacuum pump(not shown) or other source of suction through a valve 9 and a secondconnector 10. For the suction to work properly, the adapter 1 must besealed. When the valve 9 is pressed open, the pump applies suctionthrough the working channel 3. A gasket fitting 11 is incorporated atthe entrance of the working channel 3 on which a rubber gasket can beattached for sealing the orifice 8.

Referring to FIGS. 3-5, there is shown a bronchoscope adapter 20 of thepresent invention. The bronchoscope adapter 20 generally includes ahousing 22 a clamping block 40, a port seal 60, retainer nut 80, and aslide lock 100.

The housing 22 generally includes a female connector 24 and a maleconnector 26. The female connector 24 is shaped to fit over the gasketfitting 11 on the access port 2 of a bronchoscope handle. Preferably,the female connector 24 includes an interference surface 28 which abutsagainst a corresponding surface of the bronchoscope handle and preventsthe housing 22 from rotating when it is attached to the access port 2.The female connector 24 also defines a transverse slot 30 through whichthe slide lock 100 is slidingly housed.

The male connector 26 includes an external thread 32 that engages theretaining nut 80 and defines an inner lumen 34. The male connector 26mates with the retaining nut 80 and allows the retaining nut 80 tocompress the clamping block 40 between the retaining nut 80 and thehousing 22.

The clamping block 40 is an elastomeric component constructed of anelastomeric material such as rubber or silicon, or any other appropriateelastomeric material. The clamping block 40 defines an inner lumen 42and resides partially within the inner lumen 34 of the male connector 26of the housing 22 and partially within the retaining nut 80. The innerlumen 42 of the clamping block 40 has a first diameter when the clampingblock 40 is in an uncompressed state. The first diameter is sized toreceive tools used with the bronchoscope. When the retaining nut 80 istightened against the housing 22, the clamping block deforms, reducingthe inner lumen 42 to a second diameter that is smaller than the firstdiameter such that a seal is formed against the tool.

The inner lumen 42 is interrupted by valve 44, which is elasticallybiased to a normally-closed state. The valve 44 blocks the passage ofair through the clamping block when the access port 2 of a bronchoscopeis not in use. When a tool is inserted through the inner lumen 42, thevalve 44 is forced out of the way to an open position.

The clamping block 40 may include a beveled collar 46 radiating from itsouter wall. The beveled collar 46 includes a beveled surface 48 and aflat surface 50. The flat surface 50 is configured to be acted upon by aspacer ring 52, which is, in turn, acted upon by the nut 80 whentightened. The spacer ring 52 is constructed of a rigid material suchthat it provides a surface against which the nut 80 may slide whenrotated thereagainst. The spacer ring 52 thus reduces the degree towhich rotational motion of the nut 80 is transmitted to the elastomericmaterial of the clamping block 40. The beveled surface 48 acts against acorresponding surface the housing 22 to prevent axial movement of theclamping block 40 when the nut 80 is tightened. The beveled surface 48also transmits axial compression to an inward deformation of the centrallumen 42 such that any tool disposed within the central lumen 42 issqueezed by the clamping block 40. Additionally, the central lumen 42 ofthe clamping block 40 may include a narrowing 54 to assist in forming aseal around a tool.

The port seal 60 is an elastomeric gasket that allows the femaleconnector 24 of the housing 22 to form a seal against the gasket fitting11 of the access port 2. The port seal 60, preferably, is shaped tosnap-fit into a correspondingly shaped lip 62 of the housing 22. Theseal 60 may be formed of the same material as the clamping block 40. Theseal 60, however, is separate from the remaining components of theadapter 20. Separating the seal 60 from the rest of the adapter 20further isolates any rotational force imparted by the retaining nut 80.This isolation ensures the seal between the bronchoscope adapter 20 andthe access port 2 is not compromised. This isolation also facilitateseasy turning of the nut 80.

The retaining nut 80 is a female component that has an internal thread82 that corresponds to the thread 32 of the housing 22. The retainingnut 80 also forms an inner lumen 84 that receives a portion of theclamping block 40. Preferably, the inner lumen 84 is partially definedby an inner sleeve 88 that extends downwardly from the top of theretaining nut 80 and slides inside the inner lumen 34 of the housing 22when the retaining nut 80 is mated with the housing 22. The inner sleeve88 acts upon the spacer ring 52, which in turn presses the flat surface50 of the beveled color 46 of the clamping block 40. The retaining nut80 also includes an extension 86 that allows the nut 80 to be rotatedwith a single finger or thumb.

The slide lock 100 is constructed of a rigid or semi-rigid material anddefines a longitudinal slot 102 that has a small circular end 104 and alarger circular end 106. The slide lock 100 is slidingly containedwithin the slot 30 of the housing 22. The larger circular end 106 islarge enough to pass over the gasket fitting 11 of the access port 2 ofthe bronchoscope handle 4. Once in place over the gasket fitting 11, theslide lock 100 may be pushed to one side to a locked position wherebythe small circular end 104 is engaged around the neck of the gasketfitting 11, thereby locking the housing 22 to the access port 2.

In operation, the ease of use of the improved bronchoscope assembly 20becomes readily apparent. With one hand, a physician is able to grab thehousing 22 of the bronchoscope assembly 20 and place it over the accessport 2 of the bronchoscope handle. With one finger, the slide lock 100is slid to a locked position, thereby securing the bronchoscope assembly20 to the bronchoscope. Inserting a tool into the working channel 3through the bronchoscope adapter 20 is also simplified due to theeasy-turning design of the nut 80.

Although the invention has been described in terms of particularembodiments and applications, in the context of a bronchoscope andbronchoscopic tools, it should be appreciated that other applicationsusing other type of endoscopes and endoscopic tools also fall within thescope of the present invention. One of ordinary skill in the art, inlight of the teaching, can generate embodiments and modificationswithout departing from the spirit of or exceeding the scope of theclaimed invention. Accordingly, it is to be understood that the drawingsand descriptions herein are proffered by way of example to facilitatecomprehension of the invention and should not be construed to limit thescope thereof.

What is claimed is:
 1. An adapter for a bronchoscope comprising: ahousing; a retaining nut configured to mate with the housing, whereinthe retaining nut forms a lumen therethrough; a clamping block definingan inner lumen and contained between the housing and the retaining nutsuch that tightening the retaining nut against the housing compressesthe inner lumen, reducing a diameter of the inner lumen; and a spacerring between the retaining nut and the clamping block, wherein thespacer ring transfers axial force from the retaining nut to the clampingblock while preventing transmission of rotational force from theretaining nut to the clamping block, wherein a portion of the clampingblock passes through the lumen of the retaining nut.
 2. The adapter ofclaim 1 further comprising a gasket seal contained within the housingsuch that when the housing is placed over a gasket fitting of abronchoscope access port, the gasket seal is compressed between thehousing and the gasket fitting.
 3. The adapter of claim 1 furtherwherein the housing defines a transverse slot.
 4. The adapter of claim 3further comprising a slide lock contained within the transverse slot. 5.The adapter of claim 4, wherein the slide lock defines a longitudinalslot having a small circular end and a larger circular end, wherein thelarger circular end is sized to fit over a gasket fitting of abronchoscope access port, and wherein the smaller circular end is sizedto engage a surface of the gasket fitting.
 6. The adapter for abronchoscope of claim 1 wherein the retaining nut comprises an extensionusable to tighten the retaining nut with a single finger or thumb. 7.The adapter for a bronchoscope of claim 1 wherein the retaining nutcomprises an inner sleeve that extends downwardly inside the housing andacts upon the spacer ring when the retaining nut is tightened.
 8. Theadapter for a bronchoscope of claim 1 wherein the clamping block iselastomeric.